Supportive home visits to prevent childhood injuries (home safety education)

Conclusion: Convincing evidence for effectiveness

Three article are reviewed; two consider supportive home visits in general and one considers the use of baby walkers (which can be considered as a specific parenting safety skill/practice).

Concerning supportive home visits the next two conclusions are formulated:
- Roberts et al. (1996) show that supportive home visits appear to be able to substantially reduce rates of childhood injury.
- Kendrick et al. (2008) show that parenting interventions, most commonly provided within the home using multi-faced interventions may be effective in reducing child injury.
Both conclusions are mainly related to interventions provided to families at risk of adverse child health outcomes. Therefore, it is not clear how generalisable these outcomes are to different population groups.

Concerning the use of baby walkers it can be concluded that supportive home visits appear to be effective in reducing parents' baby walker use and possession.

Note: besides the Cochrane review by Kendrick et al. (2008) there is also a journal article available that covers the same topic (two publications are the same). We did note make a background document for the journal article. To be complete we do provide the complete reference:
Kendrick, D., Barlow, J., Hampshire, A., Stewart-Brown, S, & Polnay, L. (2008). Parenting interventions and the prevention of unintentional injuries in childhood: systematic review and meta-analysis. Child: Care, Health and Development, 34, 682-695.

Recommendations (for research & practice)

Suggestions for future research:
Future research is needed to explore the mechanisms by which supportive home visits reduce injury, the features of parenting interventions that are necessary or sufficient to reduce injury and the generalisability to different population groups.

Suggestions for practice and policy:
It is not clear how generalisable the intervention is to different population groups. The evidence at present relates mainly to interventions provided to families at risk of adverse child health outcomes.

Review Date: 16/08/2010
Version: 2.0
Status: Publish

Procedure
Articles (reviews) and reports were included that were published between 1996 and 2010, in English and Dutch. The outcomes of the study were reviewed by the Dutch Consumer Safety Institute.

Strategy: An online literature search was performed by a researcher of the Consumer Safety Institute and after this a more thorough search was performed by the documentation centre of CSI (Catalog CenV, Pubmed, Injury lit, Google, Websites, 'Grey' literature). Results of each search were compared on differences and potential missed studies were added. First the titles and then abstracts were scanned in order to include relevant studies. In the case of insufficient information obtained from abstracts the full text articles were obtained. Relevant articles were scrutinized and background documents were created. In addition, relevant references of included articles were checked on new and relevant articles (i.e., snowball search).

The outcomes of the study were reviewed by an expert in the field of child safety in the summer of 2010.

Background documents

Does home visiting prevent childhood injury? : a systematic review of randomised controlled trials (version 1)
Ian Roberts, Michael S. Kramer, Samy Suissa (1996)

Promoting child safety in primary care : a cluster randomised controlled trial to reduce baby walker use (version 1)
Denise Kendrick, Rachel Illingworth, Amanda Woods .. [et al.] (2005)

Parenting interventions and the prevention of unintentional injuries in childhood : systematic review and meta-analysis (version 1.0)
D. Kendrick, J. Barow, A. Hampshire ... [et al.] (2008)